Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1164671384 |
---|---|
Provider Name | Davida Ann Thompson |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-2536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 17/06/2021 |